Mindfulness self-help for health care professionals

Stress and anxiety are among the most significant reasons for staff sickness absence in the NHS. The provision of psychological support for healthcare staff may have the potential to improve staff job satisfaction and reduce staff stress and burnout. Mindfulness-based interventions (MBIs) are one type of psychological approach that has gained particular research interest in recent years. MBIs may have the potential to reduce stress and improve staff wellbeing. A fully powered randomised control, followed on from a pilot study, aimed to look at the effects of the effectiveness of a mindfulness-based self-help intervention for healthcare staff and the factors that may mediate any effects found. A total of 133 participants were recruited for the study. The results showed that participants in the intervention arm of the study reported a decrease in stress, anxiety and depression and an increase in wellbeing compared to controls. Further to this it was found that mindfulness is a mediator for self-compassion which increased wellbeing

Global Projections of Household Numbers Using Age Determined Ratios

A new method based upon age determined population ratios is described and used to estimate household population intensities (households per person). Using an additive and a bounded model household projections are given to 2050 for the world and to 2030 for seven fertility transition subgroups (cohorts) of the countries of the world. Based upon United Nations 2002 Revision data, from an estimated 1.56 billion households at 2000, household growth to 2030 is projected to be an additional 1.1 billion households, whether population increase is 1.3 billion persons under the United Nations low fertility variant or 2.7 billion persons under the high fertility variant. At that date over one third of all households are projected to be Chinese or Indian. By 2050 it is projected that there will be 3.3 billion households with a 95 per cent confidence interval on modelling error only of ± 0.5 billion. This compares with 3.2 billion in the Habitat: Global Report on Human Settlements 1996. The apparent similarity of total household growth under various scenarios conceals a wide range in the growth of household intensities across fertility transition cohorts. It is suggested that models, projections and error be reviewed biennially and that household and population projections be produced jointly.Household projections, world, age ratios, fertility

Dynamics of a disabled population in Morocco

BACKGROUND: The disabled population constitutes a class of people needing special care and necessitating important economic and social effort. METHODS: In this paper, using specific parameter settings, partial differential equations are used to model the temporal change of the proportion of the disabled population in Morocco. RESULTS: Combining different forms and values of the parameters, a numerical method is proposed and three scenarios are considered. These forms and values are determined by data fitting and simulation. CONCLUSIONS: The experiments show clearly the dynamical evolution of the disabled population with time and age according to each scenario

Modelling the cost-effectiveness of public awareness campaigns for the early detection of non-small-cell lung cancer

Background: Survival rates in lung cancer in England are significantly lower than in many similar countries. A range of Be Clear on Cancer (BCOC) campaigns have been conducted targeting lung cancer and found to improve the proportion of diagnoses at the early stage of disease. This paper considers the cost-effectiveness of such campaigns, evaluating the effect of both the regional and national BCOC campaigns on the stage distribution of non-small-cell lung cancer (NSCLC) at diagnosis. Methods: A natural history model of NSCLC was developed using incidence data, data elicited from clinical experts and model calibration techniques. This structure is used to consider the lifetime cost and quality-adjusted survival implications of the early awareness campaigns. Incremental cost-effectiveness ratios (ICERs) in terms of additional costs per quality-adjusted life-years (QALYs) gained are presented. Two scenario analyses were conducted to investigate the role of changes in the ‘worried-well’ population and the route of diagnosis that might occur as a result of the campaigns. Results: The base-case theoretical model found the regional and national early awareness campaigns to be associated with QALY gains of 289 and 178 QALYs and ICERs of d13 660 and d18 173 per QALY gained, respectively. The scenarios found that increases in the ‘worried-well’ population may impact the cost-effectiveness conclusions. Conclusions: Subject to the available evidence, the analysis suggests that early awareness campaigns in lung cancer have the potential to be cost-effective. However, significant additional research is required to address many of the limitations of this study. In addition, the estimated natural history model presents previously unavailable estimates of the prevalence and rate of disease progression in the undiagnosed population

Shotgun Proteomics Identifies Serum Fibronectin as a Candidate Diagnostic Biomarker for Inclusion in Future Multiplex Tests for Ectopic Pregnancy

Ectopic pregnancy (EP) is difficult to diagnose early and accurately. Women often present at emergency departments in early pregnancy with a 'pregnancy of unknown location' (PUL), and diagnosis and exclusion of EP is challenging due to a lack of reliable biomarkers. The objective of this study was to identify novel diagnostic biomarkers for EP. Shotgun proteomics, incorporating combinatorial-ligand library pre-fractionation, was used to interrogate pooled sera (n = 40) from women undergoing surgery for EP, termination of viable intrauterine pregnancy and management of non-viable intrauterine pregnancy. Western blot was used to validate results in individual sera. ELISAs were developed to interrogate sera from women with PUL (n = 120). Sera were collected at time of first symptomatic presentation and categorized according to pregnancy outcome. The main outcome measures were differences between groups and area under the receiver operating curve (ROC). Proteomics identified six biomarker candidates. Western blot detected significant differences in levels of two of these candidates. ELISA of sera from second cohort revealed that these differences were only significant for one of these candidates, fibronectin. ROC analysis of ability of fibronectin to discriminate EP from other pregnancy outcomes suggested that fibronectin has diagnostic potential (ROC 0.6439; 95% CI 0.5090 to 0.7788; P>0.05), becoming significant when 'ambiguous' medically managed PUL excluded from analysis (ROC 0.6538; 95% CI 0.5158 to 0.7918; P<0.05). Fibronectin may make a useful adjunct to future multiplex EP diagnostic tests

Iron-catalysed, general and operationally simple formal hydrogenation using Fe(OTf)(3) and NaBH4

An operationally simple and environmentally benign formal hydrogenation protocol has been developed using highly abundant iron(iii) salts and an inexpensive, bench stable, stoichiometric reductant, NaBH(4), in ethanol, under ambient conditions. This reaction has been applied to the reduction of terminal alkenes (22 examples, up to 95% yield) and nitro-groups (26 examples, up to 95% yield). Deuterium labelling studies indicate that this reaction proceeds via an ionic rather than radical mechanism

Diagnosis of cancer as an emergency: a critical review of current evidence

Many patients with cancer are diagnosed through an emergency presentation, which is associated with inferior clinical and patient-reported outcomes compared with those of patients who are diagnosed electively or through screening. Reducing the proportion of patients with cancer who are diagnosed as emergencies is, therefore, desirable; however, the optimal means of achieving this aim are uncertain owing to the involvement of different tumour, patient and health-care factors, often in combination. Most relevant evidence relates to patients with colorectal or lung cancer in a few economically developed countries, and defines emergency presentations contextually (that is, whether patients presented to emergency health-care services and/or received emergency treatment shortly before their diagnosis) as opposed to clinically (whether patients presented with life-threatening manifestations of their cancer). Consistent inequalities in the risk of emergency presentations by patient characteristics and cancer type have been described, but limited evidence is available on whether, and how, such presentations can be prevented. Evidence on patients' symptoms and health-care use before presentation as an emergency is sparse. In this Review, we describe the extent, causes and implications of a diagnosis of cancer following an emergency presentation, and provide recommendations for public health and health-care interventions, and research efforts aimed at addressing this under-researched aspect of cancer diagnosis